桡背侧逆行岛状皮瓣转移修复拇指皮肤缺损的临床应用

目的 探讨桡背侧逆行岛状皮瓣修复拇指皮肤缺损的方法及疗效.方法 2009年1月至2014年1月,应用桡背侧逆行岛状皮瓣修复28例拇指皮肤缺损患者.缺损面积1.0 cm×1.5 cm~2.2 cm×3.0 cm.结果 术后28例皮瓣全部存活,其中3例术后第l天皮瓣出现暗红,有水泡形成,拆除皮瓣蒂部部分缝线后,血运改善,经换药处理后愈合,其中2例术后2月出现甲床处疼痛,经手术后症状消失.随访时间9~12月,平均随访10.5月.拇指皮瓣颜色与周围组织相近,外形不臃肿,质地柔软,触、痛觉恢复.皮瓣感觉S1~S3,指间关节活动良好.皮瓣供区无疼痛,无瘢痕增生.结论 桡背侧逆行岛状皮瓣具有解剖恒定、皮瓣质量好等特点,是修复拇指皮肤缺损的有效方法.

Clinical application of the dorsoradial reverse flow island flap transfer for repair of the thumb skin defects

Objective To explore the method and effectiveness of repairing the thumb skin defects by the dorsoradial reverse flow island flap. Methods 28 cases of the thumb skin defects were treated by the dorsoradial reverse flow island flap implan-tation from January 2009 to January 2014. The size of defects were ranged from 1. 0 cm×1. 5 cm to 2. 2 cm×3. 0 cm. Results All the cases were survival after surgery. In 3 cases, the flap occurred dull red with blister on day after surgery, but patient's blood circulation improved after removing several pedicle stitches, and the wound healed after dressing changes. The hyponychium pain occurred in 2 ca-ses after two months, and then healed after surgery. All the cases were allowed to follow up for 9 to 12 months ( 10. 5 months on aver-age). The appearance, color and texture of thumb flaps were satisfactory, and the senses of pain and touch were recovered. The sensory of flaps was ranged from S1 to S3. The interphalangeal joint was active. The donor site of flaps had no pain or scar hyperplasia. Conclusion The dorsoradial reverse flow island flap features constant anatomy and good quality, which is an effect method to repair the thumb skin defects.